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Blood Gases.

For clinicians and paramedic personnel who are uncomfortable with the often challenging task of interpreting arterial blood gases, this program is excellent. Blood Gases is produced by Dr Bruce Argyle, an emergency medicine physician. It provides an excellent basic review of the concepts essential to the interpretation of and appropriate use of arterial blood gases. In addition to a tutorial, the software includes a computerized blood gas calculator for determination of acid-base disorders and A-a gradients.

The program was tested on an IBM-compatible computer and was easily run from both floppy and hard disks. Although there is no installation program provided, Blood Gases was easily installed on the hard drive by copying the files to a designated directory. The program begins promptly with a simple Start command when the user is in the appropriate directory. Before using the program, the operator must enter the normal blood gas values of the appropriate laboratory (the high and low normal values of pH, [PO.sub.2], [PCO.sub.2], [HCO.sub.3], and base excess). In addition, an average barometric pressure for the altitude in the user's geographic location is necessary. I found this information all easily obtainable from our hospital laboratory.

Once started, the user may choose from seven tutorials on blood gas measurements. (In addition, a computerized blood gas interpretation program is readily available.) The tutorials present didactic information, and administer drills on recognition, calculation, and interpretation. Topics include recognition of normal values, acid-base disturbances, and use of A-a gradients. In addition, bicarbonate therapy and dose calculation drills are available. I found each of the tutorials to be useful and easily understandable but too basic for most physicians. For educational purposes and training of paramedic personnel, this program would be excellent tool. An accompanying booklet also gives a written synopsis of the information in the tutorials, which can be used without the program for future reference.

The computerized blood gas evaluation tool could be valuable to anyone who needs to quickly calculate A-a gradients or bicarbonate dosing. This program considers the effect of nasal oxygen as well as [O.sub.2] by mask. However, because Blood Gases requires access to a computer, its use would be limited to settings where one is available. While there is no substitute for the physician's ability to use and interpret laboratory reports, this program would be helpful when rapid calculation is essential--for example, in the emergency department.

In conclusion, Blood Gases appears to be a useful tool for both educational and clinical applications. For the price, it would certainly be a cost-effective teaching aid as well as useful addition to any physician's software library.

John P. Zubialde, MD Department of Family Medicine The University of Oklahoma Oklahoma City

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Author:Zubialde, John P.
Publication:Journal of Family Practice
Article Type:Evaluation
Date:Aug 1, 1993
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